바로가기  >

Abstract
Purpose: We intend to investigate the oncological efficacy and feasibility of local consolidative therapy (LCT) through a meta-analysis method.

Materials and methods: Four databases including PubMed, MEDLINE, Embase, and Cochrane library were searched. Target studies are controlled trials comparing outcomes of LCT versus a control group. Primary endpoints are overall survival (OS) and progression-free survival (PFS).

Results: A total of 54 studies involving 7,242 patients were included. Pooled analyses showed that the LCT arm could achieve improved OS with pooled odds ratio of 2.896 (95% confidence interval [CI], 2.377 to 3.528; p < 0.001). Regarding PFS, pooled analyses showed pooled odds ratio of 3.045 (95% CI, 2.356 to 3.937; p < 0.001) in favor of the LCT arm. In the subgroup analyses including the studies with reliable comparability (e.g. randomized studies or intentionally matched studies without significant favorable prognosticator in LCT arms), pooled odds ratio was 2.548 (95% CI, 1.808 to 3.591; p < 0.001) favoring the LCT arm regarding OS. Regarding PFS, pooled OR was 2.656 (95% CI, 1.713 to 4.120; p < 0.001) which also favored the LCT arm. Subgroup analyses limited to the randomized controlled trials (RCT) were also performed and pooled odds ratios on OS and PFS were 1.535 (95% CI, 1.082 to 2.177; p=0.016) and 1.668 (95% CI, 1.187 to 2.344; p=0.003). The rates of grade ≥ 3 complications related to LCT was mostly low (< 10%) and not significantly higher compared to the control arm.

Conclusion: Pooled analyses results of all included studies, selected studies with reliable comparability, and RCT's demonstrated the survival benefit of LCT. These consistent results suggest that LCT was beneficial to the patients with oligometastasis.

Affiliations

Chai Hong Rim 1, Won Kyung Cho 1 2, Jong Hoon Lee 3, Young Seok Kim 4, Yang-Gun Suh 5, Kyung Hwan Kim 6, Eui Kyu Chie 7, Yong Chan Ahn 2, Oligometastasis Working Group, Korea Cancer Association
1Department of Radiation Oncology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.
2Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
3Department of Radiation Oncology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
4Department of Radiation Oncology, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.
5Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
6Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
7Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.